1) “How do I know if I need neck liposuction or a facelift or both?”
Neck liposuction alone (without a facelift) can be used very effectively in select patients. Typically (not always) submental (hey, what’s that word mean? sub = under / mentum = chin / submental = under the chin) liposuction alone is indicated for younger patients with excellent skin elasticity and very little excess skin or jowling. Facelift is performed to address sagging skin or jowling. Skin resurfacing addresses fine wrinkles and textural (surface) skin imperfections. The best results are often obtained with a combination of liposuction, facelift and skin resurfacing because elimination of fat (making it available for fat injections in the smile lines if needed), excess skin and textural wrinkles are addressed simultaneously.
One sign of a good surgeon is one who can tell the difference between realistic and unrealistic expectations from submental liposuction and one who will be truthful about meeting each patient’s desires. Our biggest referral source is from satisfied patients – ones who have had realistic expectations and were satisfied with results.
2) How long will neck liposuction last?
Typically five to ten years, although neck liposuction results are variable based on weight changes`, general health, genetics and general skin care to name a few. For patients who maintain their health, ten years is not unrealistic.
3) Does weight loss or weight gain affect the amount of neck fat I have?
Changes in weight of 15 kilograms or more will effect the results of neck liposuction.
4) What about my droopy double chin and jowls?
Most patients undergo neck liposuction at the same time as facelift. This has several advantages. It allows us to use the fat in another area for cosmetic enhancement (such as for lip augmentation) while simultaneously reducing the bulky area around the neck. Removing the excess fat under the chin and neck results in a more defined neckline. Tightening the muscles as well as the skin eliminates jowling resulting in a more clearly defined jaw line. Most patients are very pleased with neck liposuction results when combined with facelift to address double chin and jowls. Neck liposuction alone has very little beneficial affect on the excess skin that creates double chin or jowls.
5) Will neck liposuction help with my wrinkles?
As we stated above, neck liposuction is indicated for patients with excellent skin elasticity and very little skin damage from the sun or premature aging. Neck liposuction may provide a little improvement however it will not meet the expectations of most patients whose primary concern is wrinkles. It is most common that patients with superficial wrinkles and/or jowling are better served with a combination of procedures that may include facelift, submental liposuction with possibly skin resurfacing. Keep in mind that similar to liposuction, a facelift is not performed to address the surface or textural changes (such as fine wrinkles) in the skin.
6) Do I need a chin implant?
It is not uncommon for patients who are learning about neck liposuction to gain an appreciation for the underlying principles of beauty, including symmetry and balance. One of the benefits of computer imaging is the ability for the surgeon to give you a good idea ahead of time about the overall balance of your face, including whether you are a candidate for a chin implant would look. If your chin appears balanced with the forehead and face, you do not need to consider a chin implant. Chin implant can be performed through the same incision used for neck liposuction.
7) Will I still look like “me?”
Will I still look like “me” after cosmetic surgery? Many of our patients report that, upon return to work and routine daily activities, friends and acquaintances make the following remarks: “Gee you look great. Did you change your hairstyle?” or “Have you been on vacation?” Retaining your uniqueness is the sign of a successful procedure. Although the change may be significant to you, it’s not uncommon that friends and family don’t really notice the specific changes unless patients request dramatic changes.
8) I had a neck liposuction somewhere else and I don’t like my result. Can you “fix” it?
Most likely. Again, this question can best be answered on an individual basis. Less than satisfactory results from a neck liposuction can result from a wide range of causes – including unrealistic expectations of what neck liposuction can accomplish, postoperative complications or poor technique on the part of the surgeon to name a few. Corrective measures are often determined based on the cause.
It’s not uncommon for patients who have previously had cosmetic surgery to be referred to the Lindsay House. Although patients may want immediate adjustments to the original plastic surgery, patients should wait one full year before undergoing revision cosmetic surgery.
First of all, final results of cosmetic surgery are not evaluated until one full year postoperatively. It takes a year for postoperative swelling to subside and healing to be complete. Changes, however subtle, continue throughout the 12-month course. As time goes by, features refine as the swelling resolves. These refinements sometimes are enough for a result to be deemed acceptable.
A second consideration is scar formation. Revision cosmetic surgery is challenging enough without battling through scar tissue that has not matured. Scar tissue is somewhat more compliant in the hands of the surgeon when it has been allowed to soften over time. Even after a year the presence of scar tissue makes revision surgery more complex.
If a surgeon recommends revision cosmetic surgery at less than one year, at the very least obtain a second opinion. Give your original surgery every possible opportunity to “settle” and refine before undergoing another surgery.
9) Why is a revision cosmetic surgery more difficult than a first-time surgery?
Many reasons. First, after any surgery, scar formation creates a thick, tough layer that is more difficult to work with than original tissue. Second, the original location of (anatomical) landmarks have been altered. Third, the overall skill level required to perform a successful revision is greater. Revision plastic surgery can take a little longer because of corrections that need to be made as a result of the initial surgery. It is best to provide a patient with a realistic picture of exactly what can be accomplished prior to undergoing another surgery. Revision cosmetic surgery has humbled even the most experienced facial plastic surgeon and – at the same time – has been the most rewarding.
10) How much pain will I have?
Most patients who have neck liposuction tell us how surprised they are at how mild the discomfort is that they experience. Patients more typically complain of tightness from swelling or a pulling sensation under the chin. Understandably, after any surgical procedure, some discomfort can be expected. All patients are provided with prescriptions for pain medication. Patients sometimes use the prescription medication two to three days after surgery and then switch to Extra Strength Acetaminophen. It is uncommon for patients to report unmanageable pain after surgery.
11) Tell me about the numbness associated with a neck liposuction.
Numbness, especially near the incision lines, is most noticeable in the immediate postoperative period. Many patients report resolution of numbness within about six weeks postoperatively although patients are told to expect it to lasts up to three months.
12) Will I be awake during surgery?
Using IV sedation (medicine administered through an IV) and a local anesthetic (numbing medication administered in the operating room), patients are asleep during surgery. Patients do not hear or feel anything and are comfortable during the operation. Patients wake up very soon after the surgery is completed. Intravenous sedation is a type of anesthesia; therefore all patients must have a responsible adult to stay with them through the night following surgery. Patients may not drive for 24 hours after their procedure and this time may be longer, depending on the procedure.
13) Do I go home after cosmetic surgery?
Yes, neck liposuction procedures are performed on an outpatient basis. Because you will go home after receiving sedation, you will need to make arrangements for a responsible adult to drive you home, to stay with you overnight and to drive you to our office for your first postoperative appointment. Your first appointment is usually early in the morning on third postoperative day.
14) When can I “work out?”
Aerobic activities should be avoided for three weeks following surgery. Any activity that potentially increases blood pressure will increase the amount of time it takes for postoperative swelling to resolve.
15) How long will bruising and swelling last?
Postoperative bruising and swelling begins to resolve at the end of the first week. Full resolution of bruising or swelling may take two to three weeks. However, you may camouflage bruises fairly easily at seven to ten days with concealer stick.
16) I really want to do this but I’m nervous. What if I get stressed?
It’s ok to be nervous. (Frankly, we would be nervous if you were taking this step lightly!) One of the best ways to deal with nervousness is to see what other patients have gone through. Take a moment to look at Before and After Photos and read our Patient Diary where patients share their experience with cosmetic surgery. Check out our board certifications in Selecting a Surgeon. Remember, an educated patient knows when and if the time is right to proceed.